THE  PROPOSED  SITE  OF  THE  MEDICAL  SCHOOI 

(THE  PRESBYTERIAN^HOSPITAL) 


ARLOTT] 


AS  THE  LOCATION  OF  THE 
CLINICAL  YEARS  OF  THE 

Medical  Seliool  of 
Mortli  Garoliea 


PREPARED  AND  PUBLISHED  BY 

THE  CHAMBER  OF  COMMERCE 


IJL?. 


Cliarlotte  m  the  Loeatiee  of  the  Clieieal 
Yesiirs  of  the  Mediesil  Sehool 
of  North  Carolma 


CHK  CHARLOT.1K  CHAjMIjKR  C)1^  C(3\I]\1KRCK  of  the  Citv  of  Char¬ 
lotte  presents  the  following  facts  and  arguments  in  sup])ort  of  its  petition 
that  the  clinical  years  of  the  proposed  North  Carolina  Medical  College  he 
])laced  in  the  City  of  Charlotte: 

The  supreme  consideration  in  deciding  on  the  location  of  the  clinical  years  of 
a  medical  school,  are:  1st,  amount  and  variety  of  clinical  material,  and  2nd,  the 
ability  of  local  physicians  to  furnish  such  assistance  as  the  school  authorities  may 
desire  in  connection  with  teaching.  In  both  of  these  regards  we  respectfully  submit 
that  Charlotte  surpasses  any  other  possible  location  in  the  State. 

The  Clinical  School  of  Medicine,  in  order  to  be  prepared  to  teach  and  to  heal, 
to  bless  and  to  serve,  must  be  planted  where  its  needs  can  he  met.  W'e  shall  here 
demonstrate  that  Charlotte  can  he  expected  to  supply  the  essential  resources  for  such 
a  school.  Here  is  offered  the  location  where  need  and  resource  can  best  meet. 


I.  Charlotte’s  Clinical  Material 

In  considering  a  given  location  and  its  possibility  as  a  clinical  material  ])roduc- 
ing  territory,  consideration  should  he  given  both  to  the  number  of  inhabitants  and 
their  character ;  that  is  to  say,  whether  or  not  they  are  the  kind  of  people  who  will 
be  likely  to  patronize  a  charitable  or  semi-charitahle  hospital  and  out-patient  clinic 
and  allow  themselves  to  be  used  for  clinical  study.  According  to  the  latest  direc¬ 
tory,  Charlotte  and  the  territory  closely  adjacent  thereto  and  which  is  considered  a 
part  of  the  city,  has  a  population  of  61,000.  There  is  an  interurban  car  line  leading- 
through  the  industrial  section  of  Mecklenburg  and  Gaston  Counties,  making  about 
54,000  additional  persons  accessible  to  the  hospital  and  out-patient  department  by 
cheap  electric  car  transportation.  Three  systems  of  railroads  enter  Charlotte,  and 
railroad  tracks  come  in  from  eight  different  directions,  and  more  than  100  pas¬ 
senger  trains  enter  and  leave  the  city  every  day.  Also  there  is  a  veritable  net  work 
of  good  roads  around  the  city  and  leading  to  adjacent  towns,  which  have  great 
industrial  populations.  Patients  from  every  section  of  the  region  may  he  i)rought 
to  Charlotte  quickly  and  comfortably.  Within  a  radius  of  twenty-five  miles  of 
Charlotte,  according  to  the  official  United  States  Census,  there  live  211,425  people; 
within  a  radius  of  fifty  miles  of  Charlotte  there  lives  585,000  people,  which  is 
115,000  more  than  the  number  living  within  a  like  distance  of  Richmond.  Within 
100  miles  of  Charlotte,  there  is  a  population  of  1,972,000,  which  is  68,000  more 
than  the  population  within  the  same  distance  of  Atlanta,  Ga. 

The  United  States  Census  Bureau  reports  as  of  January  1,  1920,  the  follow¬ 
ing  populations  within  the  stated  distances  of  the  following  cities . 


Twentv-Five  Miles  Radius — Charlotte,  210,000;  Winston,  194,000;  Creens- 
horo,  1<S6,000;  Raleigh,  172,000;  Durham,  148,000. 

Moreover,  Charlotte  is  the  center  of  this  territory — the  commercial  center, 
the  l)anking  center,  as  well  as  the  center  of  the  greatest  hydro-electric  power 
develo])ment  in  the  United  States,  with  its  attendant  industrial  ex])ansion.  And 
Charlotte  is  now  the  acknowledged  medical  center  of  this  vast  industrial  region. 
It  is  not  simplv  located  in  the  center  of  this  region,  hut  is  the  huh  toward  which  all 
this  region  gravitates. 

Uhe  po])ulation  which  will  furnish  the  greatest  amount  of  clinical  material  is 
the  industrial  ])0])ulation  accessible  to  the  hospital  and  out-patient  de])artment  hy 
electric  car  lines.  It  is  well  enough  to  consider  the  accessibility  by  rail  and  motor 
transportation,  it  is  true  that  a  large  number  of  people  in  moderate  circumstances 
have  automobiles,  hut  it  is  an  undeniable  fact  that  the  people  who  will  patronize 
the  hosi)ital  and  the  out-patient  department  will  he  largely  of  the  class  which  does 
not  have  money  to  s])end  purchasing  automobiles  or  paying  taxi  fare.  The  out¬ 
patient  department  will  he  chiefly  dependent  on  ])ersons  who  can  come  on  the  elec¬ 
tric  cars.  Of  course,  every  one  knows  that  persons  attending  an  out-patient  depart¬ 
ment  are  persons  with  minor  ailments,  and  they  will  not  he  willing  to  come  any 
great  distance  by  automobile  or  train.  Also,  we  believe  that  persons  who  will  he 
useful  for  teaching  ])urposes  in  the  hospital  will  necessarily  l)e  persons  who  will 
come  on  the  car.  The  hos])ital  clinic  must  have  a  large  number  of  persons  who 
have  acute  and  infectious  diseases.  Persons  with  these  diseases  cannot  come  anv 
great  distance  l)y  automobile  or  rail.  They  recpiire  immediate  transportation.  Con¬ 
sequently,  while  we  are  advancing  the  net  work  of  good  roads  and  railroads  as  a 
persuasive  argument,  we  l)elieve  that  the  outstanding  fact  which  makes  the  j)0])ula- 
tion  in  and  adjacent  to  Charlotte  available  for  clinical  purposes,  is  the  electric  car 
lines  reaching  all  parts  of  the  city  and  extending  out  through  ^Nfecklenhurg  and  into 
the  mill  sections  of  Gaston  County.  Even  if  we  disregard  altogether  the  territory 
served  by  the  interurhan  system  which  leads  into  Charlotte,  we  are  convinced  that 
the  inhabitants  of  the  City  of  Charlotte  and  its  immediate  suburbs  will  furnish 
unaided  a  wealth  of  clinical  material  which  will  he  amply  sufficient  to  su])plv  the 
hospital  and  out-patient  department. 

4'en  years  ago  there  was  located  in  Charlotte  the  North  Carolina  Afedical  Col¬ 
lege,  which  conducted  an  out-patient  clinic.  This  out-patient  clinic  had  an  average 
of  60  persons  |)er  day.  When  we  realize  that  in  these  ten  years  Charlotte  and 
territory  immediately  adjacent  thereto  have  increased  enormously  in  ])0])ulation, 
it  will  he  seen  that  a  college  and  out-patient  clinic  serving  only  Charlotte  and  its 
adjacent  territory  could  easily  furnish  many  more  than  the  required  100  ])atients 
per  day. 

The  Health  Department  of  the  City  of  Charlotte  now  o])erates  a  charity  clinic 
and  it  has  an  average  of  seventy-five  ])atients  ])er  day.  In  this  connection,  it  must 


4 


be  rememl^ered  that  this  is  run  as  a  municipal  clinic  with  all  its  drawbacks  and 
limitations.  Patients  outside  the  county  are  refused  treatment.  There  is  no  effort 
made  to  develop  the  clinic  and  it  is  looked  upon  merely  as  a  method  for  takin"  care 
of  the  city’s  indigent.  Therefore  many  patients  are  discouraged  from  a])plying. 
This  clinic  is  not  adequately  housed.  The  city  Health  Officer  gives  it  as  his  opinion 
that  it  could  he  easily  enlarged  and  prol)ahly  doulded  if  proper  encouragement  were 
given  to  persons  attending  it.  A  clinic  of  double  this  size  could  easily  he  developed 
by  a  University  Hospital. 

The  American  Medical  Association  puts  down  as  one  of  the  requirements  for 
a  Medical  College,  the  necessity  of  having  an  out-patient  clinic  with  an  average  of 
100  patients  per  day.  The  foregoing  facts  aljout  the  old  North  Carolina  Aledical 
College  and  the  present-day  municipal  clinic  clearly  demonstrate  that  with  any  sort 
of  care,  attention  and  organization,  a  college  clinic  would  be  attended  by  anywhere 
from  100  to  200  persons  per  day  coming  from  Charlotte  itself.  As  the  present 
municipal  clinic  is  managed,  little  attention  is  paid  to  many  of  the  specialties,  such 
as  Eye,  Ear,  Nose  and  Throat,  Neurology,  Gynecology,  etc. 


CHARLOTTE^S  PRESENT  HOSPITAL  FACILITIES 


There  are  at  present  seven  hospitals  in  Charlotte,  with  a  capacity  of  365  beds, 
as  follows : 


Presbyterian  Hospital  _ 

Charlotte  Sanatorioum _ 

St.  Peter’s  Hospital - 

Mercy  General  Hospital - 

Charlotte  Eye,  Ear,  Nose  and  Throat  Hospital - 

Tranquil  Park  Sanatorium - 

Good  Samaritan  Hospital - 

Total _ 

Patients  in  Hospital - 

Surgical  - - - 

Medical  - 

Practitioners  - 

Specialists  - 


1911 

1921 

42 

93 

48 

78 

40 

65 

16 

45 

30 

—  — 

25 

15 

24 

161 

360 

3,600 

8,212 

2,500 

4,808 

1,100 

3.404 

42 

108 

8 

60 

In  1921  there  were  admitted  to  the  Charlotte  Hospitals  8,212  patients,  and 
of  this  numlier  40  per  cent  came  from  outside  of  iMecklenlmrg  County.  1  his 
demonstrates  that  Charlotte  is  already  a  medical  center  fully  capable  of  maintaining 


a  teaching  hospital  of  200  beds.  Besides  the  quantity  of  clinical  material,  the 
question  of  variety  is  of  considerable  moment.  Of  the  8,200  hospital  patients  in 
Charlotte  last  year,  4,808  were  surgical  cases,  and  3,404  were  medical  cases  of 
stiff  dent  gravity  to  he  in  bed  for  study  or  treatment. 

In  addition  to  the  persons  who  are  confined  in  hospitals  in  Charlotte,  it  must 
also  be  borne  in  mind  that  there  are  an  enormous  number  of  persons  who  receive 
treatment  from  physicians  in  Charlotte  that  do  not  go  to  the  hospital.  We  do  not 
mean  to  say  that  all  of  the  persons  who  are  confined  in  hospitals  in  the  City  of 
Charlotte,  or  all  of  the  persons  who  receive  treatment  at  the  hands  of  Charlotte 
physicians  will  be  available  for  clinical  study,  but  we  think  it  perfectly  sound 
argument  to  say  that  20  per  cent  of  this  number  would  he  available  in  connection 
with  the  hospital  and  out-patient  department  of  the  University  Medical  College, 
and  any  unusual  case  at  any  time  could  be  used  for  teaching  purposes.  In  such 
clinics  as  G.  U.  and  surgery  50  to  60  per  cent  of  private  patients  are  available  for 
teaching  purposes. 

The  patients  who  are  in  the  medical  college  hospital  must  be  selected  as  to  the 
diseases  from  which  they  are  suffering  and  consequently  it  is  absolutely  essential 
that  the  territory  surrounding  the  hospital  be  such  as  will  furnish  a  mixed  variety 
of  every  known  kind  of  physical  disease  and  ailment  in  proper  proportion  in  order 
that  the  clinical  training  of  the  students  may  be  well  rounded.  The  primary  object 
of  this  hospital  is  not  to  furnish  charity  for  certain  of  North  Carolina’s  indigent, 
but  to  furnish  the  young  doctors  of  North  Carolina  with  typical  cases  of  every 
known  disease  and  ailment;  the  hospital  should  have  such  a  clientel  as  the  young 
doctor  would  expect  to  have  in  after  life.  The  hospital  should  have : 


OBSTETRICAL  MATERIAL 

The  American  Medical  Association  lays  down  the  following  as  its  standard  for 
a  iMedical  College  in  reference  to  obstetrics : 

“At  least  six  maternity  cases  should  he  provided  for  each  senioi 
student,  who  should  have  actual  charge  of  these  cases  undei  the  supei 
vision  of  the  attending  physician.  Careful  records  of  each  case  should  he 
handed  in  by  each  student.” 

It  is  reasonable  to  assume  that  when  the  Medical  College  becomes  firmly  estab¬ 
lished  it  will  have  an  average  of  fifty  seniors  per  year.  This  would  require  300 
maternity  cases.  Charlotte  can  easily  furnish  this  number  of  mateinity  cases,  as 

evidenced  by  the  following  figures ; 

In  1921  there  were  born  in  the  City  of  Charlotte  1,769  babies  and  714 
additional  babies  were  horn  in  the  county,  making  a  total  of  2,483. 

It  is  certain  that  about  500  of  these  would  he  availalile  for  clinical  study.  We 


are  here  not  taking  into  consideration  the  material  which  would  also  be  available 
by  reason  of  the  development  of  such  a  department  in  the  school  and  by  reason  of 
the  proximity  of  industrial  centers,  such  as  Belmont,  Mount  Holly,  Lowell  and 
other  mill  towns  which  are  nearl)y  and  served  by  the  electric  interurban.  These 
cases  are  available  for  study  during  the  entire  course  of  their  pregnancy,  in  view 
of  the  fact  that  they  are  all  within  easy  reach  of  the  proposed  Medical  College  by 
car  line,  all  of  them  being  within  a  maximum  ride  of  50  minutes  and  most  of  them 
being  within  a  ride  of  20  to  30  minutes. 

There  is  also  in  Charlotte  a  Maternity  Home  run  by  the  Florence  Crittenton 
Board.  This  Board  has  an  average  of  50  mothers  and  22  babies.  There  is  a  pos¬ 
sibility  that  this  material  might  be  available.  At  least  the  rare  operative  cases 
could  prolmbly  be  used.  There  is  also  soon  to  be  a  Detention  Home  for  Delinquent 
Women.  This  would  furnish  material  for  gynecologic  and  obstetrical  work. 

PEDIATRICS  MATERIAL 

There  are  two  children’s  homes  in  Charlotte  containing  113  children  at  present 
and  an  infirmary  of  22  beds  for  infants  under  four  years  of  age  is  now  in  process 
of  construction.  There  are  four  physicians  in  Charlotte  who  are  specializing  in 
pediatrics  and  their  work  is  developing  this  field  in  Charlotte  very  rapidly,  and 
they  have  a  number  of  referred  cases  which  would  also  be  availaljle  for  study. 

ORTHOPEDIC  MATERIAL 

The  only  orthopedic  hospital  between  Baltimore  and  Atlanta  is  the  State 
supported  institution  at  Gastonia,  which  is  within  50  minutes’  ride  of  Charlotte  by 
train,  electric  car  or  automol)ile.  This  fact  shows  that  at  no  other  place  in  North 
Carolina  would  it  be  possil)le  for  the  students  to  get  such  a  wealth  and  variety  of 
training  in  orthopedics  as  would  be  available  in  this  hospital  which  is  so  close  to 
Charlotte. 


NERVOUS  AND  MENTAL  CLINICS 

There  is  a  nervous  and  mental  disease  hospital  in  the  City  of  Charlotte  of  25 
beds.  The  patients  in  this  hospital  together  with  the  patients  in  the  general  hos¬ 
pitals  of  the  city  would  furnish  a  proportionate  variety  of  cases  of  this  nature  for 
study. 

EYE,  EAR,  NOSE  AND  THROAT  CLINICS 

The  only  eye,  ear,  nose  and  throat  hospital  in  the  South  will  be  completed  in 
Charlotte  by  the  end  of  the  current  year.  This  hospietl  will  have  30  beds  and  will 
be  equipped  with  all  of  the  latest  apparatus  for  treatment  of  diseases  of  these 
organs.  To  indicate  the  great  variety  of  diseases  in  this  line  of  work  in  Charlotte, 
there  were  2,500  tonsil  and  adenoid  operations  in  1921.  There  are  13  physicians 


8 


in  the  City  of  Charlotte  who  are  specializing  in  eye,  ear,  nose  and  throat  work, 
resulting  in  Charlotte’s  already  having  become  one  of  the  great  eye,  ear,  nose  and 
throat  centers  in  the  entire  South. 

GENITO-URINARY  AND  SKIN  DISEASES 

The  largest  private  clinic  specializing  in  genito-urinary  and  skin  diseases  in 
the  South  is  located  in  Charlotte.  One  of  the  leading  medical  educators  of  North 
Carolina  was  recently  heard  to  say  that  this  clinic  was  the  third  best  genito-urinary 
clinic  in  the  United  States,  being  surpassed  only  by  Hopkins  and  Alayo.  There 
are  connected  with  this  clinic  eight  physicians.  In  the  year  1921  this  clinic  treated 
an  average  of  100  patients  per  day.  In  addition  to  the  cases  treated  in  this  private 
clinic,  the  City  Health  Department  had  2,343  venereal  cases  under  treatment  in  the 
year  1921. 

TUBERCULAR  CLINIC 

The  city  maintains  a  tuberculosis  clinic,  and  on  January  1,  1921,  it  had  under 
treatment  402  tubercular  patients.  During  the  year  366  new  cases  were  examined 
at  the  clinic,  140  being  discharged  as  not  tubercular,  leaving  628  cases  of  tubercu¬ 
losis  under  treatment  during  1921.  This  clinic  is  conducted  in  connection  with  the 
Charlotte  Co-Operative  Nurses’  Association,  and  during  the  year  1921  these  nurses 
paid  2,311  visits  to  these  tubercular  patients.  Arrangements  are  now  being  made 
to  build  the  first  unit  of  a  tuberculosis  hospital  which  unit  will  cost  about  $20,- 
000.00.  Mecklenburg  County  levies  an  advalorem  tax  of  two  cents  on  the  one 
hundred  dollars  valuation  to  assist  in  the  erection  and  maintenance  of  this  hospital. 
This  entire  material  will  be  available  for  teaching  purposes. 

CLINICAL  PATHOLOGY 

Clinical  Pathology  has  reached  a  high  state  of  development  in  the  Charlotte 
hospitals  under  the  unitary  direction  of  an  eminent  pathologist  whose  oiiginal 
investigations  are  well  known  to  the  medical  profession.  Foi  a  numbei  of  \ears 
he  has  been  training  laboratory  technicians  and  sending  them  out  to  othei  paits  of 

the  State. 

CLINICS  FOR  TREATMENT  OF  DEGENERATIVE  DISEASES 

The  usual  County  Home  of  100  lieds  is  available  for  the  study  of  chronic 
diseases  and  those  incident  to  old  age. 

X-RAY  AND  RADIUM 

Remarkaljle  development  is  now  taking  place  in  Charlotte  in  X-Ray  work. 
There  are  already  d2  N-Rav  machines  in  Charlotte.  One  clinic  is  piepaiing  to 
install  a  deep  therapy  machine  of  the  most  modern  type.  In  this  clinic,  in  addition 


9 


to  their  X-Ray  machines  for  diagnostic  and  treatment  purposes,  there  is  a  supply 
of  radium  for  the  treatment  of  appropriate  cases. 

GENERAL  SURGERY 

There  are  15  surgeons  in  Charlotte,  four  of  these  being  recent  arrivals.  In 
1921  these  11  surgeons  performed  4,808  major  operations,  exclusive  of  numerous 
minor  operations  and  treatment  of  ambulatory  cases. 

GYNECOLOGY 

There  are  five  men  in  Charlotte  who  do  principally  gynecological  surgery. 
This  indicates  a  high  development  of  this  branch  of  surgery  which  would  furnish  a 
large  clinic  to  the  Medical  School. 

The  Home  for  Delinquent  Women  would  add  materially  to  this  clinic. 

INTERNAL  MEDICINE 

In  1921  there  were  3,404  medical  cases  hospitalized  in  Charlotte.  There  are 
eight  physicians  specializing  in  internal  medicine,  with  an  average  of  5,000  cases 
per  year. 

ACUTE  DISEASES,  INCLUDING  CONTAGIOUS  AND  INFECTIOUS 

In  1921  there  were  in  Charlotte  many  cases  of  diphtheria,  typhoid,  pneumonia, 
scarlet- fever,  whooping-cough,  measles  and  mumps.  This  indicates  a  wealth  of 
acute  diseases  that  could  be  utilized  for  immediate  study.  Most  of  these  cases  could 
not  be  transported  because  of  the  State  laws  requiring  quarantine. 

G  ASTRO-  ENTEROLOG  Y 

Gastro-enterology  is  represented  by  two  specialists  who  have  a  large  clinic  and 
devote  themselves  exclusively  to  disease  of  the  stomach,  intenstines  and  bile  tract. 

PUBLIC  HEALTH  WORK 

There  are  three  whole-time  public  health  officers  carrying  on  the  work  of  the 
City  and  County,  and  the  quality  as  well  as  the  scope  of  this  work  would  afford 
valuable  practical  training  in  both  urban  and  rural  public  health  activity  in  meeting 
the  Southern  climatic  and  racial  health  problems. 

II.  Charlotte’s  Medical  Personnel 

When  the  proposition  of  placing  the  last  two  years  of  the  Medical  School  in 
Charlotte  was  first  discussed  with  President  Chase  and  Doctor  Manning,  they  were 
given  definitely  to  understand  that  the  University  authorities  would  not  be  embar- 


10 


rassed  hy  the  local  medical  profession  seeking  professorships.  The  University 
is  free  to  import  a  complete  whole  or  part-time  faculty,  as  may  seem  best.  All 
clinical  medical  schools,  however,  must  have  a  clinical,  adjunct,  or  assistant  teaching- 
staff,  varying  from  26  at  the  University  of  Virginia  to  269  at  the  College  of 
Physicians  and  Surgeons  in  New  York  City.  Should  the  school  be  placed  at  Chapel 
Hill,  these  instructors  will  have  to  he  employed  for  their  whole  time;  should  the' 
school  he  placed  in  Charlotte,  such  instructors  could  he  largely  recruited  from  the 
local  profession.  Charlotte  has  a  greater  number  of  medical  men  and  men  in  a 
greater  variety  of  special  branches  of  medicine  than  any  other  city  of  North  Caro¬ 
lina.  There  are  here  the  following  specialists : 


General  Surgery _  11 

Internal  Medicine _  8 

Gynecology  _  3 

Neurology  _  2 

Pediatrics _  4 

Orthopedic  Surgery _ 1 

Psychiatry  _  2 

Ophthalmology  _  2 

Genito  Urinary _  7 

Skin  and  Syphilis _  2 

Eye,  Ear,  Nose  and  Throat _ 11 


Clinical  Pathology _  3 

X-Ray _  3 

Obstetrics _  4 

Gastro-Ent,erology  _  2 

Tuberculosis _  1 

Anaethesia _  5 

Rectal _  1 

Health  Officers _  3 

Hospital  Administration _  2 

Radium  Therapy _  1 


Among  the  physicians  listed  above  are  many  of  the  men  who  composed  the 
faculty  of  the  North  Carolina  Medical  College.  This  college  was  in  existence  for 
eight  vears  and  these  men  obtained  teaching  experience  during  the  time  of  their 
connection  with  this  college.  Some  of  the  clinics  enumerated  above  not  only 
specialize  in  subjects,  but  the  different  divisions  of  these  specialties  have  been  highly 
developed.  Eor  example,  in  one  of  the  eye,  ear,  nose  and  throat  clinics,  it  appears 
there  is  an  ophthalmologist  and  bronchoscopist  in  addition  to  two  specialists  who 
are  following  the  ordinary  line  of  work.  In  another  genito-urinary  and  skin  clinic, 
the  work  is  likewise  divided  and  highly  specialized.  In  this  clinic  more  urethral 
stones  have  been  removed  consecutively  without  operation  than  in  any  other  like 
clinic  in  the  world. 

In  Charlotte  the  men  devoting  themselves  to  internal  medicine  are  equipped 
with  all  the  modern  contrivances  for  diagnostic  work  and  theropeutic  activities, 
including"  not  only  the  X-Ray  apparatus  1)ut  the  only  Electio-Caidiagiaph  in  the 
State,  besides  machines  for  making  metabolism  estimations. 

There  are  15  members  of  the  College  of  Surgeons  in  the  City  of  Charlotte, 
which  is  probably  twice  as  many  as  can  lie  found  in  any  other  town  in  the  State. 

The  entire  clinic  m  Charlotte  is  highly  developed,  one  man  alone  having 


11 


operated  upon  503  goitres.  This  clinic  is  more  highly  developed  than  any  similar 
clinic  in  North  Carolina. 

Other  outstanding  medical  facts  might  he  enumerated,  but  the  Chamber  of 
Commerce  is  only  bringing  forward  specific  facts  to  make  its  claim  good.  The 
Charlotte  profession  is  not  desirous  of  being  paraded  or  claiming  its  superiority, 
but  the  honest  desire  is  being  made  to  set  forth  what  Charlotte’s  assets  really  are. 

MEDICAL  LIBRARY 

The  Charlotte  Medical  Library  has  been  in  existence  for  about  ten  years.  It 
has  several  hundred  volumes.  It  is  primarily  a  Journal  Library.  It  has  bound 
copies  of  30  of  the  leading  Medical  Journals.  Some  of  these  have  been  completed 
by  filling  in  back  numbers.  These  bound  medical  journals  are  one  of  the  greatest 
assets  to  the  student  of  medicine.  The  Library  is  growing  every  year. 

THE  MECKLENBURG  MEDICAL  SOCIETY 

The  Mecklenburg  County  Society  has  most  of  the  doctors  in  the  county  as 
members.  It  meets  twice  each  month.  Its  meetings  average  about  40  members. 
The  papers  presented  are  scientific  and  well  prepard.  Men  of  prominence  are 
often  invited  to  read  papers.  In  fact  it  is  taken  as  an  index  of  the  idealistic  and 
scientific  spirit  dominating  the  profession  of  Charlotte. 

PROFESSIONAL  BUILDINGS 

Charlotte  has  two  Medical  Buildings.  There  is  the  Medical  Building,  with 
ofifices  for  about  15  doctors.  There  are  only  physicians  in  this  building.  There  is 
in  process  of  erection,  to  be  finished  about  the  first  of  1923,  the  Professional  Build¬ 
ing.  This  is  to  cost  $240,000.  It  will  have  157  ofifices.  It  will  be  open  to  physi¬ 
cians,  dentists  and  medical  and  surgical  supply  stores. 

Ill.  Finances 

Charlotte  offers  a  100  bed  hospital,  located  upon  a  magnificent  site.  The 
appraised  value  of  this  property  is  One  Half  Million  Dollars.  The  real  estate 
comprised  in  this  offer  amounts  to  ten  acres,  is  located  on  a  high  hill  and 
overlooks  the  entire  city.  It  is  in  the  midst  of  the  residential  section  and  is 
closely  connected  with  the  heart  of  the  city  by  a  double  track  car  line,  having 
7j/2  minute  service. 

To  equip  the  last  two  years  of  a  medical  school  will  require,  in  the  matter 
of  buildings,  a  200  bed  hospital,  in  which  should  be  class  rooms,  laboratories, 
museum,  library,  and  dispensary.  Dr.  Manning’s  report  estimated  the  cost 
of  hospital  construction  at  $3,500.00  a  bed,  so  that  such  buildings  at  Chapel 


12 


Hill  would  cost  from  $750,000.00  to  $1,000,000.00.  Charlotte  is  ready  to  offer 

a  100  bed  hospital  already  m  operation,  with  a  separate  nurses’  home  on 
the  site. 

The  cost  of  maintaining  hospitals  is  about  $3.50  a  day  per  patient  where- 
ever  located. The  cost  of  maintaining  200  patients  constantly  in  Chapel  Hill  will 
necessardy  fall  almost  entirely  on  the  State,  as  sick  people  will  not  pay  for  the 
privilege  of  going  to  a  small,  out-of-the-way  village  for  medical  or  surgical 
service  unless  such  service  is  admittedly  far  superior  to  that  nearer  their 
home.  Will  the  University  be  able  to  employ  better  medical  men  or  surgeons 
than  those  m  the  neighboring  towns  of  Durham  and  Raleigh?  Should  the 
hospital  be  located  in  Charlotte,  the  pay-patients  will  furnish  a  considerable 
part  of  the  expense  of  hospital  maintenance.  The  income  of  the  Presbverian 
Hospital  for  1921  was  $125,000. 

The  cost  of  maintaining  a  medical  faculty  in  Chapel  Hill  means  full  time 
heads  of  from  12  to  20  departments  as.  there  can  be  no  half-time!  men  in 
Chapel  Hill,  an  idea  relied  on  in  the  previous  report  in  estimating  the  cost  of 
a  Medical  Faculty  at  Chapel  Hill  at  $50,000.00. 


There  would  have  to  be  as 
heads  of  departments  of: 

the  lowest 

estimate  for  a  meagre  school 

1. 

General  Surgery 

7. 

Eye 

2. 

Orthopedic  Surgery 

8. 

X-Ray  and  Radium 

3. 

Gynecology 

9. 

General  Medicine 

4. 

Obstetric 

10. 

Therapeutics 

5. 

Skin  and  Genito  Urinary 

11. 

Neurology  and  Psychology 

6. 

Ear,  Nose  and  Throat 

12. 

Pediatrics 

No  provision  is  made  in  this  list  for  any  teacher  of  public  health,  serology, 

immunology,  gastro  enterology,  tropical  medicine,  clinical  microscopy,  etc., 
and  no  provision  is  made  for  research  workers  of  any  sort,  nor  for  assistants 
and  many  subjects  are  lumped  together,  such  as  skin  and  genito  urinary.  One 
State  University  in  a  small  city  last  yesr  spent  $20,000.00  on  the  Skin  Department 
alone. 

With  $50,000.00  as  previously  estimated,  these  12  professors  would  each 
receive  $4,166.00  a  pear.  As  a  matter  of  fact  no  school  can  run  on  12  teachers  ; 
Columbia,  for  instance  (1921),  had  91  professors  and  269  instructors  and 
assistants  ;  a  total  of  360.  The  University  of  Michigan  has  38  professors  and 
62  associates  at  Ann  Harbor,  population  19,516;  the  University  of  Virginia 
has  19  profesosrs  and  26  instructors  at  Charlottesville  with  10,688  population; 
the  State  University  of  Iowa  has  35  professors  and  27  lecturers  at  Iowa  City, 
po])ulation  11,  267. 


13 


Thus  the  University  of  North  Carolina  will  need  something-  between  the 
19  professors  of  Virginia  and  the  91  of  Columbia  and  between  the  26  assistants 
of  Virginia  and  the  269  of  Columbia,  and  as  these  men  will  need  entire  support 
at  Chapel  Hill,  any  estimate  below  $150,000  would  hardly  give  a  sufficient 
faculty. 

IV.  Charlotte’s  Wealth  and  Liberality 

Charlotte’s  Bank  Clearings  at  close  of  business,  September  14,  1922  (as 
reported  to  the  Federal  Reserve  Bank  Iw  Charlotte  Clearing  House  Association) 
amounted  to  $7,620,650.00;  on  September  15,  1922,  her  banking  assets  were  $38,- 
387,072.99;  the  deposits  in  her  banks,  $30,567,612.23;  her  banking  capital  and 
surplus  was  $7,819,460.76.  The  1922  taxable  value  of  her  property  was  $85,000,- 
000.00  in  round  figures,  and  the  1922  City  budget  provides  for  an  expenditure  of 
$892,771.24.  The  assessed  value  of  the  taxable  property  of  Mecklenburg  County 
for  1922  is  approximately  $125,000,000.00,  and  the  County’s  budget  is  approxi¬ 
mately  $950,000.00. 

As  to  her  liberality,  reference  should  be  made  to  her  subscriptions  for 
Liberty  Bonds,  exceeding  her  quota  on  each  of  the  five  great  loans.  Public 
subscriptions  to  meet  the  demands  have  been  regularly  made  to  the  Y.  M.  C. 
A.,  the  Y.  W.  C.  A.,  to  the  Red  Cross  and  to  the  Salvation  Army.  The 
statistics  of  the  steady  gifts  of  her  people,  year  in  and  year  out,  would  be  very 
impressive  were  they  readily  available. 

We  feel  confident  that  the  clinical  school  of  medicine  of  the  University 
would  be  safe  financially,  if  it  put  itself  on  the  heart  of  wealthy  and  generous 
Charlotte.  The  school  should  not  be  condemned  to  a  struggle  for  mere 
existence,  nor  should  it  be  located  so  as  to  be  dependent  exclusively  upon  the 
State  for  support.  Place  it  where  it  will  have  the  greatest  chance  to  invite 
private  benefactions  and  local  public  support.  In  Charlotte,  the  financial 
strain  would  be  less — the  potential  resources  greater. 

V.  The  Geographical  Location  of  a  Medical  School 

Should  be  considered  from  the  following  angles  : 

1.  The  centre  of  unoccupied  Medical  School  Territory. 

2.  Ease  of  access  to  Medical  Students  and  Universitv  Offi- 
cials  of  North  Carolina. 

3.  Location  drawing  the  largest  clinical  material. 

4.  The  situation  of  the  largest  medical  centre. 

1.  The  centre  of  unoccupied  medical  school  territory. — At  present,  there 


14 


are  medical  schools  around  N(:)rth  Carolina  at  Richmond,  Va.,  Charlestpn,  S.  C., 
Atlanta,  Ga.,  and  Nashville,  Tenn.  Certainly  North  Carolina’s  clinical  medical 
school  will  have  to  compete  Avith  these  schools.  To  obtain  the  advantage  as 
to  ability  to  draw  students,  the  logical  solution  would  seem  to  be  the  central 
point  between  these  cities.  Charlotte  more  nearly  meets  that  requirement 
than  any  other  city.  Any  clinical  school  situated  at  Chapel  Hill  or  Durham 
must  compete  strongly  with  Richmond  to  its  great  disadvantage.  Rich¬ 
mond’s  clinical  superiority  would  prevent  the  growth  of  any  great  clinical 
centre  near  it. 

2.  The  ease  of  access  of  medical  students  and  university  officials  is  a 
question  of  a  little  railroad  fare  and  time  in  travel,  a  few  times  a  year  and 
should  have  a  minor  consideration  in  comparison  to  the  vast  advantages 
off'ered  by  the  clinical  possibilities  of  a  large  centre  of  population. 

v3.  The  location  drawing  the  largest  clinical  material  is  of  great  import¬ 
ance  in  North  Carolina.  The  drawing  power  of  any  medical  centre  is  regional. 
Each  centre  draws  from  the  region  contiguous  to  it.  Few  patients  are  drawn 
long  distances.  The  region,  therefore,  more  densely  populated  offers  the 
o-reatest  possibilities.  The  Piedmont  section  of  North  Carolina  around  Char¬ 
lotte  is  the  most  thickly  settled  part  of  the  State.  Charlotte’s  future  growth 
Avill  certainly  be  fast  and  large. 

4.  The  situation  of  the  largest  Medical  center  should  count  much  in  the 
consideration  of  the  location  of  the  Clinical  Medical  College.  The  tendency 
of  the  medical  colleges  toward  the  medical  centres  is  undisputed.  The 
clinical  medical  school  not  in  a  large  city  is  a  marked  exception.  The  medical 
student  wants  his  clinical  training  in  the  medical  centre  with  a  large  and 
varied  clinical  material.  Charlotte  with  its  population  of  61,900  people  and 
211,000  in  a  radius  of  25  miles  and  now  draAving  40  per  cent  of  its  hospital 
patients  from  outside  Mecklenburg'  County  is  by  far  the  largest  medical 
centre  in  North  Carolina. 

A  city  is  the  natural  home  of  the  medical  school.  Placed  elsewhere, 
Avhere  the  situation  is  artificial  or  induced,  the  anomaly  always  calls  for 
comment,  explanation,  defense,  criticism,  qualification.  Not  so  in  a  city.  The 
people  are  there,  not  only  its  OAvn  citizens,  but  thousands  from  all  parts'  of  its 
territory  thronging  its  streets,  trading  in  its  stores,  filling  its  hospitals.  Stu¬ 
dents  Avill  gather  in  a  city.  It  is  a  “patent  fact  that  students  tend  to  study 
medicine  in  their  OAvn  States,  certainly  in  their  own  section.  In  general, 
therefore,  arrangements  ought  to  be  made  to  provide  the  requisite  facilities 
Avithin  each  of  the  characteristic  groups.  There  is  an  added  advantage  that 
local  conditions  are  thus  headed  and  that  the  general  profession  is  at  a 


16 


variety  of  points  penetrated  by  educative  influences.”  (Medical  Education  in 
U.  S.  and  Canada,  P.  145). 

Yet,  it  would  be  an  unfortunate  waste  of  resources  if,  while  suplving 
adequate  facilties  for  the  needs  of  the  unserved  region,  they  were  so  placed 
as  not  to  appeal  to  the  seeker  after  medical  education  of  the  highest  standard. 
Statistics  show  that  our  own  students  prefer  to  study  medicine  in  cities. 
Many  of  these  students  are  placed  for  the  clinical  years  of  their  student  life 
in  these  City  Medical  Schools  by  North  Carolina’s  Medical  Educators  in  the 
schools  at  Chapel  Hill  and  Wake  Eorest,  showing  conclusively,  we  believe,  that 
these  educators  encourage  their  own  students  to  attend  medical  schools  where 
a  large  number  and  a  wide  variety  of  clinical  cases  can  be  produced.  IMedical 
students  for  the  year  ending  1922  numbered  340  distributed  among  33  schools. 
Of  these,  213  attended  medical  schools  in  cities.  Of  the  remainder,  110  were 
enrolled  in  the  two  year  schools  at  Chapel  Hill  and  Wake  Eorest,  leaving  only 
17  out  of  the  total  of  340  attending  four  year  schools  in  small  towns. 

Due  regard  must  be  had  to  this  established  tendency.  Let  us  remember 
that  students  may  decide  to  go  elsewhere  if  thei  State’s  supported  school  is 
not  intellig'ently  placed  from  a  clinical  and  geographical  standpoint.  Raleigh, 
Durham,  Greensboro,  and  Winston-Salem  are  all  near  the  northern  border  of 
the  open  region  and  just  beyond  are  cities  to  which  they  may  go,  cities  with 
larger  populations  and  with  long  established  medical  schools  of  sustained 
reputations. 

VI.  A  School  of  Dentistry  for  the  Future 

North  Carolina  will  eventually  have  a  Schocl  of  Dentistry,  and  it  should  have 
a  close  organic  relationship  with  the  School  of  Medicine.  As  more  becomes  known 
a1)OUt  the  influence  of  the  teeth  upon  the  general  health,  dental  students  must  not 
only  be  taught  the  fundamental  branches  of  medicine,  but  must  take  more  of  the 
clinical  courses.  The  School  of  Medicine  should  therefore  maintain  close  contract 
with  the  teaching  of  dentistry. 

It  has  never  been  contended  that  students  of  dentistry  could  l)e  trained  outside 
of  the  city.  Schools  of  Dentistry  have  been  located  with  relation  to  the  need  of 
clinical  instruction.  Each  student  must  be  given  large  oppoitunities  to  leain  1)} 
doing.  Teachers  must  specialize,  which  means  that  the  community  must  he  large 
enough  to  supply  each  one  with  a  sufficient  numlier  of  patients  in  his  special  line 

Place  the  Clinical  School  of  Medicine  in  Charlotte  and,  when  the  State  is  iead\ 
to  add  the  School  of  Dentistry,  ideal  conditions  will  exist  for  its  location  and  no 
additional  problem  will  then  be  presented. 


17 


VII.  Relation  of  Location  of  Hospital  to  Teaching  of 

Nursing 

The  State  should  take  the  lead,  when  it  establishes  the  University  Hospital, 
in  the  training  of  nurses.  Assuming  that  we  could  persuade  forward-looking  young 
men  that  a  substantial  clinic  in  a  small  town  will  yield  to  them  the  same  results  as 
an  abounding  clinic  in  a  populous  center,  the  State  would  fall  short  of  its  duty  to 
the  people  if  it  offered  to  its  young  women  no  greater  advantages  for  the  study 
of  nursing'  than  would  he  afforded  by  a  clinical  hospital  thus  deliberately  and  inten¬ 
tionally  limited  in  its  capacity.  The  location  of  the  Clinical  Medical  School  in 
Charlotte  with  its  alrge  resources  would  present  far  greater  opportunities  for 
development  of  clinical  hospitals  and  consequently  for  the  training  of  young  women 
as  nurses. 

VIII.  Charlotte  Is  More  Desirable  As  a  Location  for  the 

Medical  School  Than  Chapel  Hill 

In  this  connection,  we  beg  to  say  that  we  see  no  sufficient  reason  for  uprooting 
the  splendid  first  two  years  of  the  Medical  School  at  Chapel  Hill,  to  place  all  four 
years  in  some  larger  town.  Our  reason  for  taking  this  attitude  is  because  the 
University  up  to  date  has  been  conducting  with  splendid  results  a  split  medical 
school.  The  chief  reason  why  it  will  not  continue  to  operate  this  split  medical 
school  with  the  same  splendid  results  is  because  it  is  having  difficulty  in  finding 
places  to  send  its  men  for  the  last  two  years  of  its  work,  it  being  necessary  to 
divide  them  up  among  a  number  of  colleges  in  various  parts  of  the  country,  not 
in  accordance  with  the  wishes  of  the  students,  but  in  accordance  with  the  number 
of  students  each  is  able  and  willing  to  take. 

In  the  early  consideration  of  this  subject  Charlotte  representatives  visited 
Chapel  Hill  and  Charlotte  was  visited  by  representatives  from  Chapel  Hill  at  our 
earnest  invitation,  because  of  the  desire  to  avoid  the  abolition  of  the  first  two  years 
at  Chapel  Hill.  This  we  were  informed  was  imminent,  as  the  Schools  of  Medicine 
teaching  the  first  two  years  only  were  fast  disappearing.  Also  there  was  the  great 
difficulty  of  ])lacing  the  students  when  they  left  Chapel  Hill,  as  the  other  schools 
hesitated  to  i)romise  to  take  students  far  ahead.  Charlotte’s  desire,  originating  in 
the  iMecklenburg  Alumni  Association,  has  always  been  to  complete  for  the  Uni¬ 
versity  its  School  of  Medicine  and  so  save  to  the  State  this  efficient  first  two  year 
Medical  School.  The  representatives  of  the  University  visited  medical  experts  in 
the  North  and  we  understood  that  their  information  was  that  while  there  were 
disadvantages  in  a  split  medical  school,  that  on  account  of  the  unique  conditions 
in  North  Carolina  it  might  he  feasible,  permissible,  and  advisable  to  establish  a 
s])lit  medical  school. 

There  are,  according  to  the  American  Ivledical  Association  Journal,  August 


18 


19,  1922,  the  following  split  medical  schools  in  the  United  States:  1.  The  Uni¬ 
versity  of  California,  at  Berkley  and  San  Francisco.  2.  College  of  iMedical  Evan¬ 
gelists,  at  Lorra  Uinda  and  Los  Angeles.  3.  Stanford  University  School  of  i\Iedi- 
cine,  at  Polo  Alta  and  San  hiancisco.  4.  IJniversitv  of  Colorado,  at  Bonlder  and 
Denvei .  5.  Indiana  Univeisity  School  of  Medicine,  at  Bloomington  and  Indian¬ 

apolis.  6.  University  of  Kansas  School  of  Medicine,  at  Lawrence  and  Rosedale,  a 
suhurh  of  Kansas  City.  7.  Cornell  University,  at  Ithica  and  New  York  City.  8. 
University  of  Oklahoma,  at  Norman  and  Oklahoma  City.  Some  of  these  are 
])lanning  to  comliine,  hut  the  fact  that  they  have  existed  successfully  for  practical 
reasons  shows  that  this  ])rocedure  is  a  possible  one  for  North  Carolina. 

Earlier  in  this  pamphlet  we  have  called  attention  to  the  fact  that  the  su})reme 
consideration  in  deciding  on  the  location  of  the  clinical  years  of  the  Aledical  School 
is  the  clinical  material.  In  oth^r  words,  it  is  not  possible  to  train  phvsicians  with¬ 
out  having  sick  people  for  them  to  study.  The  American  Medical  Association 
insists  that  there  he  clinical  material  sufficient  to  maintain  a  200  bed  hospital  which 
shall  have  a  full  variety  of  cases ;  also  an  out-patient  department  averaging  100 
patients  a  day.  Chapel  Hill,  itself,  of  course,  cannot  afford  any  such  hospital  or 
out-patient  department.  The  people  who  patronize  such  a  charitable  or  semi- 
charitable  hospital  or  out-patient  department  do  not  have  automobiles  in  which  to  be 
transported  to  Chapel  Hill ;  also  it  will  be  impossible  for  such  a  hospital  and  out¬ 
patient  department  to  receive  and  treat  acute,  infectious  and  contagious  diseases. 
The  department  of  obstetrics  will  he  almost  impossible  to  handle  on  account  of  the 
fact  that  in  order  to  get  sufficient  maternity  cases  to  supply  the  seniors,  it  would  he 
necessary  to  allow  these  patients  to  go  to  Chapel  Hill  fully  two  months  prior  to 
deliA^erv  and  they  would  have  to  he  retained  there  for  fully  a  month  after  delivery, 
which  would  be  an  enormous  expenses  to  this  State.  This  is  assuming  that  these 
cases  would  go  to  Chapel  Hill,  which  we  consider  a  very  violent  assumption.  If 
we  assume  that  300  cases  would  he  necessary  for  a  senior  class  of  50  students, 
which  is  the  minimum  requirement  set  down  by  the  American  Aledical  Association, 
and  if  we  figure  the  cost  of  each  of  these  patients  at  $3.50  per  day  for  60  days,  we 
have  an  expense  of  $63,000.00,  and,  of  course,  this  is  unthinkable. 

However,  if  we  assume  that  it  were  possible  to  maintain  the  required  hospital 
and  out-patient  department  at  Chapel  Hill,  there  would  he  another  enormous 
expense  which  would  have  to  he  met.  In  Charlotte  there  is  a  sufficient  numhei 
of  trained  phvsicians  who  would  he  willing  to  serve  as  clinical  teachers  at  low  cost, 
whereas  at  Chapel  Hill  it  would  he  necessary  to  employ  these  clinical  teacheis  at  a 
full  salary,  the  cost  of  which  would  he  enormous.  In  Charlotte,  theie  aie  cei- 
tainlv  a  sufficient  number  of  men  who  can  serve  as  clinical  teacheis.  The  ph\- 
sicians  in  Charlotte  are  highly  specialized  along  the  lines  and  in  the  manner  required 
for  clinical  teaching.  It  is  to  lie  noted  also  that  these  men  aie  m  Chailotte  in  laige 
numbers  and  everv  vear  the  number  is  being  increased.  \  oung  men  with  highh 


19 


specialized  training  are  rapidly  coming  to  Charlotte  and  the  body  of  men  which 
can  be  used  for  the  clinical  teaching  stafif  in  Charlotte  will  be  sufficiently  large  to 
enable  the  force  to  be  rotated,  thereby  keeping  the  interest  and  enthusiasm  in 
clinical  teaching  up  to  a  high  standard. 

IX.  Charlotte  Is  More  Desirable  As  a  Location  for  the 

Medical  School  Than  West  Durham 

Charlotte  has  a  population  of  61,900  people,  with  a  street  car  population 
of  54,000.  This  presents  more  sick  people  in  Charlotte  and  vicinity  than  there  are 
in  Durham  and  proportionately  means  a  greater  opportunity  to  have  a  great  medical 
school.  Charlotte  has  a  medical  profession  of  106.  This  means  that  Charlotte 
numerically  could  produce  more  teachers  than  Durham.  In  addition,  the  men  in 
Charlotte  are  more  highly  specialized,  showing  63  specialists.  The  teaching  experi¬ 
ence  gotten  by  formerly  conducting  a  medical  school  in  Charlotte  is  another  con¬ 
sideration  to  be  counted  for  Charlotte. 

By  reason  of  the  fact  that  Charlotte  is  already  established  as  a  medical 
centre,  it  will  continue  to  draw  men  who  have  a  highly  specialized  training. 
This  means  that,  as  time  goes  on,  the  number  of  available  medical  men  in 
Charlotte  to  assist  in  the  operation  of  the  Medical  College  as  clinical  teachers 
or  otherwise,  as  may  be  desired,  will  be  greater  and  greater.  Charlotte  is 
growing  rapidly.  It  is  the  centre  of  the  textile  industry  of  the  Piedmont 
region  and  a  large  amount  of  wealth  is  being  accumulated  here.  As  this 
textile  industry  increases,  the  amount  of  clinical  material  available  in  Char¬ 
lotte  will  increase.  We  do  not  foresee  any  such  development  for  the  city  of 
Durham  as  we  see  for  the  city  of  Charlotte  and,  therefore,  we  do  not  think 
that  a  mdical  school  located  there  would  have  anything  like  the  future  that 
one  located  in  Charlotte  would  have. 

It  has  been  advanced  as  an  argument  in  favor  of  West  Durham  that  it  is 
within  10  or  12  miles  of  Chapel  Hill  and,  therefore,  the  administration  prob¬ 
lems  will  not  be  as  great  as  if  the  clinical  years  were  further  away  from  the 
President’s  office.  We  respectfully  submit,  in  the  first  place,  that  when  the 
last  two  years  are  separated  as  far  as  10  miles  from  the  President’s  office, 
they  might  as  well  be  separated  as  far  as  150;  and,  in  the  second  place,  that 
this  is  a  minor  consideration  and  should  have  no  weight  when  set  up  beside 
the  other  arguments  wdrich  are  of  supreme  importance.  It  is  also  to  be 
noted  here  that,  at  the  present  time,  the  last  two  years  of  the  Chapel  Hill 
Medical  School  are  now  located  all  over  the  United  States,  being  scattered  all 
the  way  from  New  Orleans  to  Boston  and  as  far  West  as  the  Pacific  Ocean. 
For  this  reason,  we  respectfull}^  insist  that  anything  that  may  be  said  against 


20 


a  split  medical  college  applies  to  Durham  with  equal  force  as  to  Charlotte. 
One  of  the  arguments  against  a  split  medical  school  is  the  fact  that  the  last 
two  years  should  be  controlled  by  campus  influence  and  University  ideals.  If 
the  campus  influence  and  University  ideals  at  Chapel  Hill  are  strong  enough 
to  bridge  the  10  mile  gap  from  Chapel  Hill  to  West  Durham,  they  certainly 
will  be  strong  enough  to  extend  to  Charlotte.  West  Durham  is  certainly  no 
more  aflfected  by  the  campus  influence  and  University  ideals  than  Charlotte  is. 

University  spirit  and  ideals  are  transmissable.  Else,  why  educate  our 
students  in  Universities,  if  they  cannot  carry  this  spirit  and  these  ideals  with 
them  through  life?  The  converse  of  this  proposition  would  have  confined 
all  progress  to  the  spot  where  the  first  ideal  originated.  We  1)elieve  that  too 
much  stress  is  being  laid  on  the  thought  of  physical  promimity,  as  related 
to  unitary  administration,  while  the  main  consideration  is  unity  of  purpose 
and  of  ideals.  Distance  can  impede  or  even  prevent  a  certain  commerce 
between  dififerent  parts  of  the  University,  but  it  cannot  prevent  all  parts  being 
actuated  by  the  same  spirit. 

With  the  University  at  Chapel  Hill  and  its  clinical  school  of  medicine  in 
Charlotte,  both  guided  by  the  spirit  of  service  to  the  State,  l)oth  under  the 
same  control,  with  their  policies  outlined  and  their  aft'airs  guided  by  the  same 
ofificials,  and  with  the  ideals  of  both  derived  from  the  same  source,  we  feel 
certain  that  the  interests  of  one  would  l^e  the  interests  of  the  other. 

It  is  worth  considering,  too,  that  the  fact  that  the  University  occupies  the 
field  of  Charlotte  would  prevent  the  possibility  of  a  rival  medical  school  being- 
established  at  hat  location  in  the  future. 

If  these  clinical  years  are  located  at  West  Durham,  we  do  not  believe 
that  the  hospital  and  out-patient  department  vdll  get  the  full  benefit  even  of 
Durham’s  population  on  account  of  the  fact  that  West  Durham  is  several 
miles  from  the  city  of  Durham  and  there  is  only  a  single  car  line  operating 
between  the  two  places  upon  which  cars  run  at  great  intervals.  This  will 
render  the  hospital  and  out-patient  department  more  or  less  inaccessible  even 
to  the  people  in  Durham  and,  therefore,  makes  it  problematical  as  to  whether 
or  not  this  hospital  and  outpatient  department  would  be  patronized  even  by 
the  citizens  of  Durham  itself. 

There  would  be  a  strong  competition  of  Richmond  with  the  clinical 
school  at  Chapel  Hill  or  Durham.  Two  of  the  hospitals  in  Richmond  in  the 
last  five  years  treated  1,763  patients  from  North  Carolina;  50  counties  in 
western  North  Carolina  contributed  186  of  these,  while  the  50  counties  in 
eastern  North  Carolina  contributed  1,677.  This  shows  the  relatively  dom¬ 
inating  medical  position  of  Richmond  over  northeastern  Carolina.  The  pos¬ 
sibility  of  Durham  ever  becoming  a  great  medical  centre  is  very  remote  on 


21 


account  of  the  nearness  to  Richmond  and  the  drawino-  of  Riclimond,  Norfolk, 
and  Raleigli  in  competition. 

The  drawing  power  of  a  liospital  is  strictly  regional  and  there  is  no  rea¬ 
son  to  think  that  there  will  he  any  considerable  increase  in  the  number  of  sick 
])eople  in  the  territory  of  either  Chapel  Hill  or  Durham.  The  Chapel  Hill- 
Durham  territory Tvill  always  be  limited  on  the  north  by  Richmond,  on  the 
east  by  Raleigh  and  on  the  \vest  by  (ireensboro;  each  of  which  places  prob¬ 
ably  draws  patients  from  Orange  and  Durham  Counties.  To  overcome  this 
the  University  will  have  to  offer  very  much  better  medical  and  surgical  serv¬ 
ice  than  can  be  (d)tained  in  Raleigh,  Richmond  or  Greensboro,  which  seems 
wholly  improbable,  or  they  will  have  to  offer  similar  service  free  at  a  tre¬ 
mendous  ex])ense  to  the  State. 

As  bearing-  on  Durham’s  future  ])OSsibilities,  it  is  to  be  noted  that  it  is 
served  by  only  three  railroads,  each  one  of  which  is  a  branch  line. 

d'he  Ih'esident  of  the  University  of  Tennessee  has  said  that  by  having  the 
r^fedical  School  established  in  Memphis,  away  from  the  Lfniversity,  the  influence 
of  the  University  is  made  stronger  in  that  locality.  The  contention  is  made  that 
by  i)lacing  the  Clinical  Medical  School  at  Charlotte  the  interest  in  the  University 
would  he  intensified  in  this  populous  Piedmont  Section.  This  should  give  the  peo])le 
of  this  section  the  ideals  of  the  University.  It  should  give  to  the  University  more 
of  the  hnancial  support  and  the  legislative  influence  of  this  section. 

In  this  connection  Dr.  Arthur  Dean  Bevan,  who  is  one  of  the  best  known  and 
most  experienced  medical  educators  in  the  country,  and  who  is  Chairman  of  the 
Council  on  Medical  Education  of  the  American  IMedical  Association,  has  this  year 
declared  : 

“The  medical  school  should  be  located  in  and  about  the  hospital  and  the  dis¬ 
pensary  because  it  is  here  that  we  can  have  access  to  the  patient  who  is  the  object  of 
our  study.  The  opposite  point  of  view,  that  the  sciences  of  anatomy  and  physiol¬ 
ogy,  j^harmacology  and  pathology  together  form  the  science  of  medicine  and  that 
medicine  is  simply  the  application  of  these  sciences,  and  that  because  of  that  fact 
the  medical  school  should  he  located  at  the  University,  in  touch  with  these  depart¬ 
ments,  is  not  sound  and  should  not  he  considered  by  University  trustess  in  organiz¬ 
ing  and  locating  the  medical  department.” 


22 


PRESBYTERIAN  HOSPITAL 

CHARLOTTE,  N.  C. 


TEN  ACRES,  OF  OVER  300  TREES,  WITH  50  VARITIES, 
THE  STATELY  OAK  PREDOMINATING 

One  hundred  Beds,  handsomely  furnished  rooms,  with  and 
without  connecting  baths.  Seclusive  Obstetrical  Department. 
The  best  of  Operating  Rooms  (Four).  Always  ready  for 
emergency  cases.  Well  equipped  X-Ray  and  Bacteriological 
Laboratories,  in  charge  of  specialist  of  experience.  Hydro- 
theraphy  Massage  and  Exercise  Departments  now  open. 
Full  corps  of  trained  nurses. 


PRESBYTERIAN  STANDARD  PUB.  CO.,  CHARLOTTE,  N.  C. 


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